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Transforming Heart Failure Management: A Path to B ...
Transforming Heart Failure Management: A Path to B ...
Transforming Heart Failure Management: A Path to Better Outcomes and Aligned Care Delivery
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Video Transcription
Video Summary
The UnityPoint Health team presented their comprehensive approach to transforming heart failure management across their integrated healthcare system serving Iowa, Illinois, and Wisconsin. Recognizing heart failure as a leading cause of morbidity, mortality, and healthcare costs, they embarked on a multi-phase project beginning in 2022 to standardize care, improve outcomes, and align quality delivery. Their multidisciplinary clinical effectiveness team identified critical challenges: high mortality, inconsistent heart failure definitions, underutilization of guideline-directed medical therapies (GDMT), outdated EMR workflows, and disjointed care between hospitals and outpatient clinics.<br /><br />Key initiatives included establishing uniform heart failure definitions and classifications, aligning diagnostic criteria, and integrating guideline-recommended treatments into EMR order sets. The focus on the four pillars of GDMT (SGLT2 inhibitors, ARNIs, beta blockers, MRAs) led to a significant increase in their use, reducing mortality risk substantially. Three focused subgroups addressed treatment guidelines, care coordination, and documentation/education.<br /><br />Care coordination efforts emphasized discharge planning, timely follow-up within 3-7 days, medication access, and patient education using the "WATCH" framework (Weigh daily, Activity, take medications, Call provider, Heart healthy diet). The team enhanced clinician education via forums, standardized materials, and EMR decision support tools.<br /><br />Outcome tracking through a real-time dashboard showed marked improvements: in-hospital mortality dropped from an observed-to-expected ratio of 1.83 to 1.07, and discharge on zero GDMT medications decreased from 22.3% to 12.7%. Local market initiatives included hiring a heart failure coordinator for patient education, coordinating care transitions, and offering cardiac rehab and community cooking classes to reinforce lifestyle changes.<br /><br />The team underscored the necessity of multidisciplinary engagement, standardization, continuous education, and robust data monitoring to sustain improvements in heart failure care and patient outcomes.
Keywords
public reporting
cardiovascular healthcare
National Cardiovascular Data Registry
healthcare quality measurement
transparency
risk aversion
clinical registries
hospital rankings
patient informed decisions
California TAVR reporting
heart failure management
UnityPoint Health
guideline-directed medical therapies
GDMT
EMR integration
care coordination
multidisciplinary clinical team
mortality reduction
patient education
outcome tracking
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